Dear @Nicola DaCosta I would suggest DHEA (Dehydroepiandrosterone) 10mg take 2 capsules daily at breakfast https://swanson.co.uk/p/swanson-dhea-10mg/#!q=1&_ship-from=bw-uk&_label=us
Please try for at least three months, and then do let me know how the sexual drive has changed.
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Hello Dr Frontino. First of all, thank you for the opportunity. I hope you don't mind me posting a question, I'm looking for advice on behalf of my wife. It's not easy to talk about, but she's 52 and has absolutely no interest in getting intimate anymore. She's either exhausted by the end of the day, or is simply "not in the mood". We've talked about this before and I don't know what I could do to help her as it's affecting our marriage to a great extent. Is this normal? I don't think she'd be open to talk to a doctor but if there's anything we can try by ourselves to improve the situation, I'd love to know. Thank you very much in advance.
First of all, please let your wife know that when she feels like it she can always write to me through a discreet Inbox message.
Normally there can be more than one reason for a woman's sexual desire to be affected. So I would suggest that all potential factors be taken into consideration.
Do you feel you could identify whether there could be any life/work/relationship issues that may have a role in making her feel somewhat overwhelmed with concerns or constant thoughts?
This article I am pasting here for you can be helpful in combing through the most likely points to think over: https://www.webmd.com/sex-relationships/features/loss-of-sexual-desire-in-women#1
Last, but definitely not least, if your wife has other symptoms such as irregular or fast hearbeat, hot or cold sweats, hair loss, weight gain, I would recommend that she speak to her GP about all of these. Sometimes loss of sexual desire is a symptom of an underlying medical problem.
Your wife will surely value that your concerns come from your profound wish for her to feel confident in herself and her body. Please do let me know if you have any further thoughts.
Hello Giada again, I was wondering if spotting after sex is normal? I haven't had any periods in the last year. However, this morning I noticed some light red blood. I'm a little worried. Thank you in advance.
Bleeding/spotting/pain after sex is never normal. I would recommend a PCR test to rule out bacterias Ureaplasma, Mycoplasma, Trichomonas and Gardnerella. Unfortunately these are not offered by the NHS at all. However, you might find self-collection kits to be purchased online. The test can be done if you have not had any antibiotic treatments in the past 30 days nor used any vaginal lubricants/creams/pessaries in the past two weeks.
Also, please discuss with your GP about this spotting as a pelvic ultrasound scan should be done. Have you had your cervical smear regularly every three years?
What is the best product you would recommend for vaginal dryness? Thank you
The choice of the product depends primarily on what specific symptoms you have, your age and also on which medications you are taking.
If you have itchiness/burning and discharge, it would be of help to first have a swab to rule out local infections that often cause symptoms.
Please do let me know more details so I can help you better.
With kind regards,
Hi please could you advise..I am 52 still having periods and been on cyclical HRT for 18 months. Mid cycle last month I also bled heavily for a few days. An internal scan was normal and didn't give me any answers. My periods recently are also very painful. Should I try a different HRT as I've heard that the Oestrogel I use doesn't always absorb well enough? I also use Utrogestan on days 15-26. Is it best to use this internally or orally as my GP said either is fine? I also feel I've gained weight since using HRT especially on my thighs, is this normal and would an alternative HRT be better?
Many thanks for your help,
Hi Dr Giada,
I have recently started on 1mg estrogel and progesterone tablets. Following intercourse I have real bladder sensitivity and bacterial vaginosis repeatedly which is becoming really troublesome. Can you suggest anything I can take daily as a preventative measure. I feel very uncomfortable and have also noted a reduced labido which is also troubling as I was hoping the Estrogen would prevent this from happenning.
I'm very sorry to hear about your symptoms. If you have had relapses of BV, please take a specific women's probiotic such as Optibac For Women one capsule daily before breakfast for the next three months, as BV is often related to a diet that is too rich in sugars (including protein bars, fruit juices and smoothies) and processed foods. Other bacteria are often found alongside BV, but because these are not picked up by the common high vaginal swabs, I identify these through a first-morning urine test which you can easily do through https://onlinedoctor.superdrug.com/extended-STI-test-kit.html. This test can be carried out when no antibiotics have been used for the past 30 days. Ureaplasma and Mycoplasma are two bugs that are often the cause of these urinary and vaginal symptoms appearing after intercourse.
With regards to the decreased sexual drive, it may be worth waiting for the test results and potential treatment, as often enough our local discomfort and pain will naturally cause anxiety and decreased desire due to the fear of developing symptoms again. If you feel this is not the case, you might try Femal pollen extract to improve this in the long run.
Please let us know how all this goes.
Thankyou so much for your advice which I have been trying to get from GP for over 6 months!!!! I am happy to try anything that works and find this forum so helpful when you are new to this. I will be trying all you suggested to get some level of normality back in my life.
hello I am a breast cancer survivor. estrogen and progesterone positive cancer. my life was very stressful when the cancer was discovered. i was 50 . i had a full mastectomy - no chemo , no tamoxifen- totally discharged 2 years ago. I am now 61 and would love to go on hrt- body idential to protect my brain for the future. can you advise please. thank you
I am looking for advice on navigating apts with my GP. I have had symptoms for 4 months. Started with vaginal itch that wouldn’t go away. She tested for YI but test was negative. Referred me to menopause specialist but wait time is 6 months (I am 57 on HRT for 7 yrs). Symptoms progressed to bad stinging/burning in vulva area. She prescribed Corticosteroid cream .05%. This calmed the stinging but only seems to mask the symptoms which start to return when time to reapply. Now I have noticed small bumps under my clitoris. The whole area is very tender. Still can’t wear pants. What tests should I be asking for and any other advice would be helpful.
Thank you for posting this, as this is definitely a very important topic.
Breast cancer survivors will be safer not taking hormonal treatments, as this can often increase the chance of recurrences.
Luckily, we do have nonhormonal drugs which are very helpful for hot flashes and other symptoms. Please talk to your GP about your symptoms, so that together you can tailor treatment to your needs.
Some herbal medications have been demonstrated to be effective and safe in the treatment of some of the most common menopausal symptoms.
Relief from menopausal symptoms can also surely be greatly improved by modifying our lifestyle. Regular aerobic activity and reaching a healthy weight have been shown to significantly reduce hot flashes and improve the mood.
Please update us on how you do.
I am sorry to read about the symptoms you have been dealing with. Given the symptoms and the bumps you have described, it would be important to have these assessed by your GP or a Specialist at a Sexual Health Clinic.
If you feel you have also been experiencing stomach and bowel symptoms, please try taking Optibac For Women one capsule before breakfast for the next 20 days, and keep a bland diet for a week, staying away from sugars and processed foods. Many cases of genital inflammation can be caused by a prolonged imbalance of the bowel environment due to sugars and additives in our diet.
Please let us know how this goes.
How can I increase my libido? I'm not allowed HRT due to family history.
Changes in sexual drive/libido occur gradually and very often even starting from as early as in our 30s. This is due to a natural reduction in our hormonal production.
However, sometimes the decrease in libido can actually be caused by silent health issues, such as with a mild underactive thyroid or high sugar levels. I would surely recommend speaking to your GP in order to screen for these conditions first and foremost, prior to attempting nonhormonal treatments for the low sexual drive.
I have had PGAD since I was 6 years old and they suspect vulvodynia. In December 2020 at the age of 36 I had a full hysterectomy. Since then my dearest ovaries have not recovered and I’ve gone into perrimenopause. I am wearing a 50mg oestrogen HRT patch but my PGAD and vulvodynia symptoms have increased in intensity. My breasts are still really store and I’m still sweating excessively at night.
Any tips on things I should try?
Also, I’ve only been on 50mg for 1 week, prior to that I was given a low dose of 25mg for 2 weeks. I have had symptoms of peri menopause for months but no one would believe me so I only recently had bloods to prove it.
I am sorry to hear you are still having trouble with vulvar symptoms, night sweats and breast tenderness.
There are certainly other treatment alternatives which you can discuss with your GP or with your Consultant Gynaecologist. However, I would first of all recommend addressing the breast symptoms so that these can be assessed with an ultrasound or mammogram.
I hope this will help.
I need your input on menopause & mood swings. I had a hysterectomy when I was 43 & didn't start having; what I think are menopause-related; mood swings. They mostly consist of crying spells & I have trouble sleeping also. I'm 61 now & don't know what to do. My primary doctor recommended a psychologist/therapist, but I need other points-of-view. What do you think? Thank you.
I am 63 had hystorectomy 23yr ago .used vagifem on and off 10 year. I still have ovires had hystorectomy for fybroids. I get tummy cramps and all symptoms of V.A.and when up vagifem to 3 or 4 week settles. Asking is normal to have tummy cramps with V.A. it dose work with more vagifem. But is it safe life long
Iv read dr nrwson 4 vagifem only equivalent to 2 hrt tabs a year.please help my gp hopeless many thanks x
I am a 63 year old on hrt, my endometrium is 7mm and they think I have a polyp. I have no bleeding or symptoms. Is it necessary to have a hysteroscopy at this stage? If I stopped hrt would this reduce my endometrium and polyp?
I am cautious about general anaesthesia as I have Multiple sclerosis, and concerned about hysteroscopy as speculum is very painful and makes me bleed. Tissue is obviously thinner, and there is always a chance of perforation.
Thank you for any advice.
I am in full menopause and struggling with hot flushes and weight loss I am taking vitamin B12, manga leaf capsules and turmeric all in a soya milk shake My energy levels are good but I can not lose the weight no matter how much exercise I do, I am also suffering from sever hot flushes at night time
Is what Im taking ok or do I need to look at something different
Hello Dr. Frontino, I started menopause in September. I immediately started having insomnia. After having insomnia for a few weeks, I then started having bad anxiety from the lack of sleep. On top of all that, I get butterfly feeling/nausea in my stomach. I’m taking medicine to sleep, anxiety and for acid reflux. I’ve told my primary care and gastroenterologist that it’s all related to menopause but it’s being treated separately. Do you have any suggestions on what I can do instead of taking all this medicine for my menopausal issues? Thank you!
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